Tuesday, August 31, 2010

SHEA: Mandatory Vaccination Of Health Care Workers

# 4855

The vaccination rate among health care workers (HCWs) against seasonal influenza runs abysmally under 50%, and in recent years there have been multiple calls to make yearly vaccination a requirement of employment.

For infection control professionals, the advantages are obvious. Influenza exacts a heavy burden on patients, their families, and co-workers. Requiring vaccination would undoubtedly save lives, and reduce costs.

But for many HCWs, the issues are more about personal rights to decide what they will inject into their bodies. And that has left this hot-potato issue in the wings.

Earlier this summer the CDC released their proposed infection control guidelines, where they strongly urged – but did not mandate – flu vaccinations for HCWs.

Strategies to improve HCP vaccination rates include providing incentives, providing vaccine at no cost to HCP, improving access (e.g., offering vaccination at work and during work hours), and requiring personnel to sign declination forms to acknowledge that they have been educated about the benefits and risks of vaccination.

While some have mandated influenza vaccination for all HCP who do not have a Contraindication, it should be noted that mandatory vaccination of HCP remains a controversial issue.

In response to what many felt was a tepid policy, Richard Whitley, MD president of the Infectious Diseases Society of America (IDSA), wrote an open letter to CDC director Thomas Frieden urging that these guidelines include mandatory influenza vaccination.

Last year New York State attempted to require vaccination as a requirement to work as a HCW, but legal challenges and vaccine shortages forced them to abandon – at least temporarily – that mandate (see New York Rescinds Mandatory Flu Shots For HCWs).

Some hospitals around the nation have adopted mandatory vaccination – or require the wearing of masks by unvaccinated workers during flu season.

In the UK, the Department of Health – while not mandating vaccination – stresses the `professional duty’ of all HCWs to get the vaccine.

Which brings us to a press release and a positions paper from SHEA (Society for Healthcare Epidemiology of America), – endorsed by the IDSA - that calls for the mandatory vaccination of all HCWs against seasonal flu each year.

First an excerpt from the press release, followed by a link to the position paper.

Vaccination Should Be Requirement for Continued Employment for Healthcare Personnel, Epidemiologists and Infectious Disease Physicians Say

(Arlington, VA)— Influenza vaccination of healthcare personnel is a professional and ethical responsibility and non-compliance with healthcare facility policies regarding vaccination should not be tolerated, according to a position paper released today by the Society for Healthcare Epidemiology of America (SHEA). The paper, published in this month’s Infection Control and Healthcare Epidemiology journal and endorsed by the Infectious Diseases Society of America (IDSA), stresses influenza vaccination of healthcare personnel as a core patient safety practice that should be a condition of both initial and continued employment in healthcare facilities.

According to SHEA, their recommendations apply to all healthcare professionals in all healthcare settings, regardless of whether the professional has direct patient contact or whether he or she is directly employed by the facility. The policy also applies to students, volunteers, and contract workers. The only exemptions, say the epidemiologists and infectious disease physicians, should be in cases of medical contraindications.

An update of an original SHEA statement issued in 2005, this paper states that influenza vaccination is the professional and ethical responsibility of healthcare professionals and that non-compliance with healthcare facility policies regarding vaccination should not be tolerated. It is endorsed by IDSA.